Innovative nitric oxide-releasing nanomaterials: Current progress, trends, challenges, and perspectives in cardiovascular therapies

Abstract

Cardiovascular diseases remain the leading cause of death worldwide, imposing a substantial impact on healthcare systems due to high morbidity, mortality, and associated economic costs. Nitric oxide (NO), a key signaling molecule in the cardiovascular system, plays a critical role in regulating vascular homeostasis, angiogenesis, and inflammation. Despite its therapeutic potential, direct NO delivery in the cardiovascular system is limited by its reactivity, short half-life, and poor bioavailability. The development of NO-releasing nanomaterials addresses these challenges by enabling controlled, targeted, and sustained NO delivery, mitigating systemic toxicity and improving therapeutic outcomes. This review provides a comprehensive overview of recent advancements in the design, functionalization, and application of NO-releasing nanomaterials for cardiovascular therapies. Key topics include the use of in vitro and in vivo models to evaluate efficacy in conditions such as myocardial ischemia-reperfusion injury, thrombosis, and atherosclerosis, as well as the role of stimuli-responsive systems and hybrid nanomaterials in enhancing delivery precision. Advances in nanotechnology, such as stimuli-responsive systems and hybrid functionalized nanomaterials for targeted delivery, have enhanced the precision and effectiveness of NO therapeutic effects for treating a wide spectrum of cardiovascular conditions. However, challenges like scalable production, biocompatibility, and integration with existing therapies remain. Future research should focus on interdisciplinary approaches to optimize these materials for clinical translation, ensuring accessibility and addressing the global problem of cardiovascular diseases.